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"As healthcare costs rise in the United States, debate is ongoing over how to obtain better value for dollars spent. In this context, the use of cost-effectiveness analysis (CEA) is more compelling than ever. This book, written by the Second Panel on Cost-Effectiveness in Health and Medicine, reviews key concepts and analytic challenges in CEA. The authors endorse the original Panels concept of a reference case and support its recommendation that analysts take a broad societal perspective; in addition, they recommend a healthcare sector perspective for a second reference case, as well as an important new framework, the Impact Inventory, for detailing costs and effects. The revisions draw on advances in the field and include three new chapters that capture research on decision modeling, methods for evidence synthesis, and ethical considerations. The volume also includes two new worked examples (Appendix A and Appendix B) to illustrate ways to implement the authors recommendations."

"ABSTRAKDemam tifoid adalah penyakit yang disebabkan oleh infeksi bakteri Salmonella typhi atau Salmonella paratyphi. Pilihan terapi demam tifoid yang bisa digunakan antara lain adalah antibiotik seftriakson, siprofloksasin, dan sefoperazon. Evaluasi penggunaan obat tersebut tidak hanya dilihat secara klinis, tapi juga secara farmakoekonomi. Tujuan penelitian ini adalah untuk menilai efektivitas-biaya seftriakson dan non-seftriakson dalam pengobatan demam tifoid. Metode penelitian ini menggunakan metode analisis efektivitas-biaya AEB . Data diambil secara retrospektif dan pengambilan sampel dilakukan secara total sampling dengan melihat catatan rekam medik dan sistem informasi rumah sakit. Pasien yang menjadi sampel penelitian adalah pasien murni demam tifoid dan menggunakan antibiotik seftriakson atau non-seftriakson pada tahun 2016 di RSUD Cengkareng. Sampel yang dilibatkan dalam analisis sebanyak 15 pasien, yaitu 10 pasien kelompok seftriakson dan 5 pasien kelompok non-seftriakson. Efektivitas pengobatan diukur dalam efektivitas persentase pasien dengan lama hari rawat kurang dari sama dengan 5 hari . Biaya didapatkan dari median total biaya pengobatan, meliputi biaya obat, biaya alat kesehatan, biaya obat lain, biaya cek laboratorium, biaya tindakan, biaya jasa dokter, serta biaya kamar rawat. Berdasarkan hasil penelitian, efektivitas seftriakson 66,67 lebih besar dibandingkan efektivitas non-seftriakson 33,33 . Total biaya pengobatan seftriakson lebih rendah Rp 1.929.355,00 dibandingkan non-seftriakson Rp 2.787.003,00 . Nilai rasio efektivitas-biaya REB seftriakson lebih rendah Rp 28.938,88/ efektivitas dibandingkan non-seftriakson Rp 83.618,45/ efektivitas . Hasil akhir menunjukkan bahwa seftriakson lebih cost-effective dibandingkan non-seftriakson.

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ABSTRAKTyphoid fever is caused by bacterial infection Salmonella typhi or Salmonella paratyphi. Typhoid fever treatment which can be used such as ceftriaxone, ciprofloxacin, and cefoperazone. The evaluation of drugs not only seen by clinical aspect but also from economic aspect. The study aimed to evaluate the cost effectiveness of ceftriaxone and non ceftriaxone for typhoid fever patients. Cost effectiveness analysis CEA was chosen to be the method of this study. Data were taken retrospectively and sampling was done using total sampling based on medical records and hospital information systems. Patients who become the samples are patients diagnosed typhoid fever only and use ceftriaxone or non ceftriaxone as the antibiotics. The number of samples were 15 patients, which included 10 patients used ceftriaxone and 5 patients used non ceftriaxone. The effectiveness is measured by effectiveness percentage of LOS less than or equal to 5 days . The cost is median of total cost, summed from the cost of drug, other drugs, medical devices, laboratory tests, physician, healthcare services, and hospitalization. Based on result study, the effectiveness of ceftriaxone 66.67 is greater than non ceftriaxone 33.33 . Total cost of ceftriaxone Rp 1,929,355.00 is less expensive than non ceftriaxone Rp 2,787,003.00 . Average cost effectiveness ratio ACER of ceftriaxone Rp 28,938.88 effectiveness is lower than non ceftriaxone Rp 83,618.45 effectiveness . The final result showed that ceftriaxone is more cost effective than non ceftriaxone. "

"Sakit merupakan suatu kejadian yang tidal: dapat diduga kapan akan menimpa seseorang. Biaya yang harus dikeluarkan juga cukup bcsar khususnya untulc rawat inap. Untuk rnengurangi beban biaya yang dilimbulkannya, salah satu cara untuk mcntransfer resiko biaya dengan memiliki asuxansi kesehatan. PT. Askes merupakan salah satu asuradur yang wajib dimiliki oleh pcgawai negeri sipil tetapi dalam pelaksanaannya, peserta masih harus mengeluarkan beban biaya sencliri (our ofpocket) karena adanya perbcdaan antara biaya sesuai tarif rumah sakit dengan tarif paket Askes. Beberapa penelitian membuktikan kondisi tersebut, sepeni di RS PMI Bogor, RSUD Kota Cilegon dan RS Persahabatan Jakarta. Sedangkan di RSUD dr. Achmad Diponegoro - Putussibau, Kabupatcn Kapuas Hulu - Kalimantan Barat belum pernah diteliti. Studi ini dilakukan untuk mengetahui gambaran, faktor-faktor apa yang mempengaruhi dan faktor mana yang paling mempengaruhi serta model prcdiksi beban biaya sendiri (our of packcl) pasien rawat inap pegerla Askcs di RSUD dr. Achmad Diponegoro-Putussibau, Kabupatcn Kapuas Hulu, Propinsi Kalimantan Barat, tahun 2005. Rancangan penelitian ini cross sectional dengan sampel sebesar 257 pasien rawat inap di RSUD dr. Achmad Diponegoro - Putussibau, Kabupaten Kapuas I-lulu - Kalimantan Barat tahun 2005. Rata-rata beban biaya sendiri (out of pocket) pasien rawat inap pcserta Askes di RSUD dr. Achmad Diponegoro sebesar Rp. 2l5,472,76 atau 20,84 % dari rata-rata pengeluaran biaya perawatan sesuai tariff RSUD. Bcban minimum sebesar Rp. 25.000,- penyakit penyulit, obat-obatan, pesertal (peserta), peserta3(isteri), pegawail(golongan I), interaksi antara lama hari rawat dengan penyakit penyulit dan interaksi antara penyakit penyulit dengan obat-obatan dimana interaksi antara lama hari rawa dengan penyakit penyulit merupakan faktor yang paling mempengaruhinya (nilai B yang tcrtinggi yakni sebesar 0,624). Setelah dilakukan uji asumsi dan uji interaksi, maka diperoleh model prediksi beban biaya sendiri = 5,743 + 0,3l3*|ama hari rawat - 0,785*tidak ada penyakit penyulit + 0,8l9*obat~obatan (Non DPHO) + 67,39'7*peserta1 + 0,179*peserta3 + l,489*pegawail + 0,26O*Interaksi penyakit penyulit dengan Obat-obatan + 37,353*Imeraksi Iama hari mwat dengan Penyakit Penyulit. Diharapkan pihak manajemen RSUD dapat menghitung tarif RSUD sesuai kondisi riil sehingga dapat digunakan sebagai bahan masukkan ke Pemda Kabupaten Kapuas Hulu untuk menetapkan kebijakan tarif dan pcmberian subsidi ke RSUD khususnya untuk golongan 1, melakukan advokasi pada PT. Askes, menyarankan penggunaau obat-obatan DPI-10 dan diharapkan juga PT. Askes dapat mempenimbangkan untuk menyesuaikan pemberian manfaat kepada. pescrta khususnya untuk pcserta dengan status kepegawaian golongan 1 yaitu bcrupa penyesuaian tarif PT. Askes sesuai dengan situasi dan kondisi rumah sakit.

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No ones could predict when they would get sick. There will be some significant amount of expenses to be paid during the time of being hospitalized. In order to reduce the amount of expenses a patient should pay, to minimalize risk of cost by having health insurance is a way of working it out. PT Askes is one of the health insurance providers which its membership is a mandatory for every public service officers in Indonesia. Yet, in the reality, a patient still have to cover some oi' his or her expenses hom his or her pocket, due to the differences between hospital fare and the expenses that is covered by Askes. Some researches bring forward eveidenoes regarding this issue, in example researched conducted in PMT hospital in Bogor, District Hospital of Cilcgon City, and Persahabatan hospital in Jakarta. While in Kapuas I-lulu District, dr. Achmad Diponegoro Hospital in Putussibau, West Kalimantan Province, such research has not been conducted yet.

This researched is to find out the influence factors, the most influence factor, and the prediction model of out of pocket of hospitalized patient with Askcs membership at dr. Achmad Diponegoro Hospital in Putussibau, Kapuas I-lulu District, West Kalimantan Province in 2005.

This researched design is cross sectional, using 257 sample of hospitalized patients in dr. Achmad Diponcgoro Hospital in Putusibau, Kapuas Ilulu District, West Kalimantan Province during the year of 2005.

The average amount of out of pocket self cost of each patient is Rp 215,472.76 or 20.84 % out of the total expenses in the district hospital. the minimum fare id Rp 25,000.- and the maximum one is Rp 2,784,000.-, depend on the number of days in hospitaL the kind of illness, medications, memberl (the person with the membership), mernber3 (the spouse), level 1 employee, thc interaction between long of stay with the type of illness, and the interaction between the complicated illness and the drugs are the most influence factor( the 6 value are the highest, which is 0,624). The assumption and interaction test, result the model of self expenses prediction model = 5,743 + 0,3 l3*long of stay - 0,785*no complicated illness + 0,8l9*drugs (Non DPHO) + 67,397*memberl + 0,179*member3 + l,489*employeel + 0,260*interaction between complicated illness and drugs + 0,260*Interaction between long of stay and complicated illness. It is necessary for the District Hospital management to calculate the fare according to the real expenses as an advocacy for the Kapuas Hulu District government for the titre and subsidiary to District Hospital policies making especially for the base level oflicer, advocacy to the PT Askes, awareness to use DPHO drugs and it's necessary for PT Askes to consider adjustment in providing the benefits for its members especially for the base level oflicer to be more in line with the current situation of the hospital."